A Case of Descending Aortic Rupture due to Blunt Chest Trauma

(Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Nagano, Japan)

Masayuki Sakaguchi Naobumi Fujii Kazunori Nishimura
Nobuyuki Yanagiya
We report a case of rupture of the thoracic descending aorta due to blunt chest trauma. An 18-year-old man was transferred to our hospital after a car accident. He was in a state of shock. The admission chest X-ray film demonstrated mediastinal widening and blurring of the aortic arch. Chest and abdominal helical CT scan showed left hemothorax, pseudoaneurysm, and hematoma of the cervix, mediastinum, and retroperitoneal space. We diagnosed rupture of the thoracic descending aorta without other injuries. An emergency operation was performed under partial cardiopulmonary bypass with systemic heparinization. The descending aorta had completely lost its continuity. Graft replacement was performed with a collagen-sealed woven Dacron graft. The postoperative course was uneventful. We suggest that high awareness and a systematic approach are needed to diagnose traumatic aortic rupture, and that enhanced helical CT scanning is helpful for diagnosis and management strategy.
@Jpn. J. Cardiovasc. Surg. 30: 89-91 (2001)